IRLF 


B    3    15M 


LIBRARY 

OF  THK 

UNIVERSITY  'OF  CALIFORNIA. 

OF" 


Received 
Accession  No.        '    ..  ..  .    Clots  .  /=;. 


,  ™       - 


Presented  to  the  Section  on  Laryngology  and  Otology,  at  the  Forty-ninth 

Annual  Meeting  of  the  American  Medical  Association, 

held  at  Denver,  Colo.,  June  7-10, 1398. 


BY  EPHRAIM  CUTTER,   LL.D.,   M.D.    (Harv.,   1856,  and 
Univ.  Pa.,  1857.) 

NEW  YOKK  CITY. 


REPRINTED  FROM 

THE  JOURNAL  OF  THE  AMERICAN  MEDICAL  ASSOCIATION 
MARCH  18,  1899. 


CHICAGO 

AMERICAN  MEDICAL  ASSOCIATION  PRESS 


7.5-?  6  7 


PHONATION. 


For  thirty  years  there  has  seemed  to  me  no  differ- 
ence between  phonation  (speech)  and  cantation 
(song),  save  in  the  length  of  the  basic  vowel  sounds. 
The  action  of  the  nares,  antra,  pharyngeal  dome, 
frontal  sinuses,  lips,  teeth,  tongue,  soft  and  hard 
palates,  epiglottis,  breath- bands  (false  vocal  cords), 
arytenoid  cartilages,  interarytenoid  band,  trachea, 
lungs,  diaphragm,  ribs,  abdominal  muscles  and  air 
are  the  same  in  both — or  to  shorten  this  text,  the 
"oripulations"  (os=mouth,  plenum— full)  are  alike  in 
both.  Indeed,  as  the  writer  showed  in  a  paper  pub- 
lished in  1873,  "speech  may  be  termed  staccato  song." 
A  year  later  this  view  was  published  as  original  in 
London  by  an  English  observer.  And  now  the  serra- 
tions on  the  cylinders  of  the  phonograph  or  gramo- 
phone have  demonstrated  the  truth  of  this  position, 
so  that  the  kinship  of  phonation  and  song  is  proved. 
These  things  being  so,  the  writer  has  thought  for 
many  years  to  ask  the  question :  Why  not  phona- 
tional  harmony  as  well  as  musical  harmony  9 

It  seems  fit  to  make  this  query  in  this  Section,  as 
without  laryngology  and  otology  it  is  impossible  to 
understand  this  subject,  and  because  the  writer's 
knowledge  has  mostly  come  from  autolaryngoscopy 
and  autorhinoscopy.  It  makes  no  difference  if  medi- 
cal doctors  as  a  whole  are  among  the  poorest  speakers. 
Phonation  is  a  physiologic  function  belonging  to  the 
wide  domain  of  medicine.  Our  country  would  be 
much  better  off  if  there  were  less  lawyers  in  legisla- 
tive bodies  and  more  physicians  there  who  could  rise. 


to  the  true  dignity  of  their  oratorio  birthrights. 
Having  looked  in  vain  to  the  professors  of  music, 
law,  theology,  oratory,  physics  and  physic,  the  writer 
presents  these  ideas  in  the  hope  that  some  of  the 
legion  of  distinguished  younger  throat  specialists 
may  perfect  them,  to  the  good  of  man. 

Starting  out  with  these  views  and  also  with  the 
sentiments  that  phonation  means  the  gift  or  commun- 
ication of  something  of  more  or  less  importance  by 
the  medium  of  speech  to  other  minds,  and  that  a 
diminution  of  this  full  gift  means  loss  and  disap- 
pointment— if  you  pay  $1  to  hear  a  speech,  and  the 
speaker  or  auditorium  is  so  faulty  that  you  hear 
only  75  per  cent.,  it  follows  that  you  have  been 
defrauded  of  25  cents — the  writer  suggests  that 
speech  should  be  in  the  chords  of  the  keynote  of  the 
auditorium,  because  Helmholtz,  a  double  doctor  of 
physics  and  physic,  averred  that  every  room  has  its 
keynote  and  because  music,  whose  keynote  is  the 
same  as  that  of  the  auditorium  where  it  is  produced, 
is  the  most  effective  and  at  its  best. 

For  example,  the  church  auditorium  of  my  boyhood 

had  as  a  keynote  F.  g  ^  Music  in  F  sung  or  played 

in  that  church  went  with  a  rhythm  and  vim  that 
roused  enthusiasm  and  made  the  walls  ring  joyously. 
In  1850  Mr.  Simmons,  the  organ- builder,  while  set- 
ting up  a  new  instrument  in  this  auditorium,  was 
voicing  the  16-foot  open  diapason  pedals.  He  had 
much  trouble  with  the  F  pipe.  A  Yale  student  home 
on  vacation  watched  him  for  hours.  Do  what  he 
could,  Mr.  S.  was  unable  to  give  an  even  temperament 
to  the  scale.  He  would  play  C,  D,  E,  F,  G,  A,  B,  C, 
over  and  over  again  and  adjust  the  voicing.  It  was 
smooth  and  even  throughout,  except  the  F  or  Fa 
pipe,  which  would  stick  out  like  double  great  primer 
type  among  pica.  Forty  years  afterward  the  student 
found  that  the  trouble  was  because  F  was  the  keynote 
of  the  auditorium,  as  it  is  of  the  majority  of  audi- 
toriums, according  to  the  writer's  experience. 


Having  found  the  musical  keynote  of  the  audi- 
torium it  is  easy  to  find  the  phonational  keynote. 
For  example,  take  the  above  auditorium,  sing  the 
bass  as  follows:  0=60  metronome. 


While  with  ceaseless  course  the  sun. 

Then  sing  the  same  staccato — 


While  with  ceaseless  course  the  sun. 

and  quicken  the  time  in  repeat  if  you  do  not  catch 
the  idea.  You  will  then  have  phonation  with  rests 
between  each  syllable.  Leave  out  the  rests  and  you 
will  have  ordinary  speech  in  the  key  of  F.  Perhaps 
the  definition  of  phonation  should  be  "staccato  song 
without  rests,"  if  such  a  thing  is  possible  in  nomen- 
clature. If  the  accomplished  members  of  this  Sec- 
tion will  study  this  phase  on  their  own  vocal  bands,  I 
think  it  will  be  understood,  with  this  reservation — it 
is  impossible  to  sing  words  with  the  living  vocal 
cords  exposed  to  view  in  the  laryngoscope,  because 
the  vowel  sounds  only  can  be  sung.  For  example, 
the  above  phrase  would  be: 


so  that  you  can  only  use  the  larynx  under  sight  or 
view  as  you  play  an  organ  or  violin.  Laryngoscopic 
song  is  simply  playing  as  on  an  instrument.  Hence 
we  iterate,  speech  should  be  in  the  keynote  of  the 
auditorium,  not  necessarily  on  the  keynote  all  the 
time;  but  that  speech  should  have  a  keynote  the  same 
as  in  song,  and  melodiously  depart  from  it,  returning 
to  the  keynote  or  its  chord  at  the  end. 

Take  "Maxwellton  Braes  are  Bonnie."  It  begins  with 
the  third  chord  of  the  key  of  C,  runs  down  to  C,  then 
jumps  an  octave  and  ends  the  first  line  on  A  in  the  key 
of  F.  But  in  the  next  line  the  song  immediately  comes 
down  to  G,  the  fifth  chord  from  C,  and  so  this  melody 


6 

runs  in  a  most  natural,  easy  and  graceful  style  and  ends 
on  the  keynote  C.  Now,  when  speech  has  the  beautiful 
musical  progression  of  this  most  exquisite  but  beau- 
tiful gem  of  Scottish  song — which  my  son,  Prof.  Ben- 
jamin Cutter,  of  the  New  England  Conservatory  of 
Music,  pronounces  to  be  one  of  the  most  admirable 
of  all  secular  songs — then  phonation  will  produce  the 
delightful  effects  of  musical  speech  sometimes  heard 
and  long  remembered.  Thus  phonation  will  be  intel- 
ligible, easy  to  utter,  easy  to  listen  to,  and  not  tire- 
some to  hearer  nor  speaker.  This  opinion  is  based  on 
facts  like  the  following :  In  1888  the  writer  had  a 
paper  to  read  before  the  AMERICAN  MEDICAL  ASSOCI- 
ATION, Section  of  Medicine,  whose  auditorium  was  a 
music  hall  with  a  holding  capacity  of  6000  people  at 
least.  About  one  hundred  and  fifty  to  two  hundred 

men  were  present.     Fortunately  the  keynote  F  [ 

was  struck  and  held,  as  confectioners  use  a  string  for 
rock  candy  crystals  that  cluster  in  a  chain  of  prisms. 
A  critic  present  said  that  the  address  was  heard  per- 
fectly and  easily.  The  speaker  got  rested  from  his 
lantern  demonstrations,  which  had  taken  most  of  the 
day  up  to  5  P.M.  and  tired  him  so  that  when  he  began 
to  phonate,  his  knees  almost  collapsed  under  him. 
This  severe  test  is  worthy  of  evidence  here. 

At  the  meeting  of  the  British  Medical  Association, 
held  in  Leeds  in  1889,  the  writer  was  a  delegate  from 
the  AMERICAN  MEDICAL  ASSOCIATION.  A  banquet 
was  held  in  Albert  Memorial  Town  Hall — 700  plates. 
In  this  auditorium,  as  usual,  the  architects  had  catered 
for  the  eye,  with  magnificent  walls  and  pillars  of  pol- 
ished variegated  marbles,  and  had  given  besides,  a 
general  visibility  of  the  platform  to  the  whole  audi- 
ence. But  so  sadly  had  the  architects  neglected  the 
ear  as  to  make  it  almost  impossible  to  hear  what  was 
said  by  the  phonators.  The  fault  did  not  all  lie  with 
the  construction  of  the  hall  as,  to  repeat,  it  is  notorious 
that  physicians  are  usually  sorry  public  speakers.  The 
writer  was  unexpectedly  called  on  to  respond  to  the 


7  -       . 

toast  for  foreign  guests.  Now,  thought  he,  is  the 
chance  to  test  this  rule  of  phonation.  Hence,  the 
main  effort  was  to  hit  the  keynote  of  the  auditorium, 
making  the  words  secondary.  This  effort  took  away 
all  stage  fear  and  made  the  speaker  feel  very  much  at 
home  before  the  brilliant  audience.  He  said:  "The 
delegate  from  the  largest  medical  society  of  the  new 
world  brings  greetings  to  the  largest  medical  society 
of  the  old.  Peace  and  good  will;  our  hearts  are  with 
you.  Long  may  you  prosper" — and  then  the  speaker 
was  interrupted  by  a  sudden  bursting  of  a  storm  and 
din  of  applause,  which  certainly  proved  that  this 
principle  of  phonation  was  correct.  It  is  needless  to 
repeat  the  rest  of  the  address,  but  it  may  be  said  that 
it  was  the  last  speech  of  the  evening,  when  all  were 
tired  out,  and  that  several  gentlemen  came  to  the 
speaker  afterward,  shook  hands  most  cordially  and 
thanked  him  for  his  speech, ^all  saying,  "because  we 
could  hear  what  you  said!  " 

At  the  Te^th  International  Medical  Congress,  held 
in  Berlin  in  1890,  the  writer  read  five  papers  and 
made  one  address  in  the  Section  rooms,  which  were 
the  salons  of  a  picture  gallery,  constructed  for  the  eye 
and  not  for  the  ear.  Consequently  it  was  very  diffi- 
cult to  hear,  and  there  was  a  habit  of  the  uninterested, 
because  not  understanding,  listeners  of  leaving  during 
the  exercises.  The  rule  laid  down  about  phonation 
was  applied  here,  and  if  interested  and  continued 
attention  of  the  audience  is  any  criterion,  speech  in 
the  chords  of  the  keynote  of  the  auditorium  was  a. 
success.  In  some  respects  this  was  the  severest  test, 
because  of  its  varied  application  and  its  uniform  sat- 
isfactoriness. 

Another  rule  which  I  venture  to  lay  down  is  that 
architects  build  auditoriums  for  the  ears  primarily 
and  for  the  eyes  secondarily. 

What  does  "auditorium"  mean?  A  place  for  hear- 
ing! How  oft  it  is  the  place  for  not  hearing!  One 
such  is  at  Saratoga,  of  bad  repute  for  hearing.  But 
even  in  this  auditorium  when  empty — which  is  deemed 


worse  than  when  full  of  people — I  found  that  phona- 
tion  in  £      ]  was  easily  audible.     There  are  two  ways 

in  which  architects  can  get  at  this : 

1.  The  concrete.  Taking  auditoriums  which  are 
known  to  be  easy  to  sing  and  speak  in.  Such  a  one 
is  the  auditorium  of  the  first  Congregational  Church, 
Woburn,  Mass.  The  late  John  Stevens  of  Boston,  its 
architect,  told  me  that  he  had  put  the  best  work  of 
his  life  into  it  and  wanted  it  to  be  his  monument.  He 
certainly  favored  the  ear  and  eye  both.  There  is  not 
a  seat  of  the  fifteen  hundred  but  commands  a  perfect 
hearing  and  view  of  the  preacher  or  speaker  at  the 
pulpit.  Prof.  Alonzo  L.  Butterfield,  Ph.D.,  of  Bos- 
ton, elocutionist,  enthusiastically  wedded  to  his  pro- 
fession, after  specially  testing  during  a  visit  made  for 
this  purpose,  pronounced  it  to  be  the  best  auditorium 
for  phonation  he  ever  met  with.  Clergymen  have 
testified  to  the  same;  singers  also.  For  several  years 
the  writer  was  a  tenor  in  the  choir  and  soloist.  It 


was  easy  to  reach  SpEEd  while   at  the  dedication  of 


this  church  the  soprano  soloist  easily  ran  up  to 

Thus,  incidentally,  is  shown  the  advantage  of  an 
aurally  correct  auditorium  for  musical  and  phonational 
performances.  Major  Ambrose  Bancroft  of  Woburn, 
Mass.,  master  carpenter,  has  given  me  the  following 
dimensions  of  the  auditorium  :  Height  of  ceiling  from 
floor,  34  feet  10  inches;  width,  80  feet;  length,  150 
feet;  width  of  side  galleries,  11  feet;  width  of  rear 
galleries,  14  feet. 

The  chapel  of  the  New  York  City  Church  of  the 
Comforter  is  easy  for  the  ear.  The  auditorium  is 
25  by  50  feet,  open  to  the  roof;  height  of  ridge  pole, 
18  feet. 

2.  Ideal.  Study  the  nodes  of  the  key  of  F,  for  example, 
and  have  the  walls  and  height  correspond  to  them. 


In  an  auditorium  already  complete  with  organ,  let  the 
organist  play  the  pedal  notes  singly  till  the  keynote  is 
found,  then  walking  in  the  direction  of  the  long  diam- 
eter of  the  auditorium,  note  when  the  tone  is  loudest 
and  weakest.  In  the  Woburn  church,  I  found  the  node 
of  the  keynote  to  be  about  fifteen  feet.  Such  physic- 
ists  as  Prof.  J.  Solis  Cohen,  M.D.,  Prof.VF.  Barker, 
M.D.,  University  of  Pennsylvania,  and  others,  would, 
I  think,  gladly  aid  architects  in  this  humane  work. 

While  I  would  have  orators  trained  for  speaking  in 
the  chords  of  the  keynote  of  auditoriums,  I  would  also 
insist  on  architects  following  the  example  of  the  late 
John  Stevens,  aforesaid,  and  give  us  auditoriums  that 
will  be  things  of  aural  and  optical  joy,  beauty  and  de- 
light as  long  as  they  endure.  But  when  architects  build 
solely  for  the  eye,  come  out  and  say  so,  eschewing  all 
use  of  the  ear,  and  when  nine  out  of  ten  of  their 
buildings  will  be  an  abomination  to  all  who  go  to 
hear  what  is  said  or  sung,  it  is  high  time  to  call  a  halt 
and  compel  them  to  take  counsel  of  the  experts  named, 
and  furnish  better  construction. 

The  following  is  a  study  in  phonational  harmony  to 
illustrate  the  recommendations  given:  Matthew  ix, 
27-38,  inclusive.  Speech  parts:  1,  text;  2,  blind  men; 
3,  Jesus  Christ;  4,  the  multitudes;  5,  Pharisees. 

It  is  natural  that  these  parts  should  be  in  different 
tones.  Voices  differ  as  much  as  speakers.  Taking 
the  New  England  (Boston)  Conservatory  of  Music 
scale,  where  A  in  the  treble  clef  has  432  vibrations  per 
second,  it  is  evident  that  1  could  use  423  vibrations  to 
the  second;  2  could  use  433;  3  could  use  434;  4  could 
use  435;  5  could  use  436  vibrations  to  the  second  of 
time,  if  they  chose  to;  even  fractions  of  these  numbers 
they  could  use.  But  for  our  purpose  of  illustration 
let  us  use  the  chords  of  F,  i.  e.,  5  below— 1:3:5:8. 

Or   using  male  voices,  let  the  text,    1,  be  |3==j  F; 
2,  blind  men  be  fcfty-;  H  F;  3,  Jesus  fc9=  =]  A;  4,  mul- 


titudes 


10 


C ;  5,  Pharisees 


C. 


Dispensing  with  verses,  the  phonational  harmony 
might  be  as  follows: 

1-   [Q  |*    [     And  when  Jesus  departed  thence  two 
blind  men  (2)  followed  him  crying  and  saying: 
2,    tK=3       Thou,  Son  of  David,  have  mercy  on  us. 


1. 


;£=]     And,  when  he  was  come  into  the  house, 

the  blind  men  came  to  him,  and  Jesus  (3)  saith  unto 
them: 


3. 
1. 

2, 
1. 
3. 


Believe  ye  that  I  am  able  to  do  this? 

They  said  unto  him, 

Yea,  Lord. 

Then  touched  he  their  eyes,  saying: 

According  to  your  faith  be  it  unto  you. 


And  their  eyes  were  opened  and  Jesus 
straitly  charged  them  saying: 

3.    t^=f        See  that  no  man  know  it. 


1. 


But   they,  when   they   were    departed, 


11 

spread  abroad  His  fame  in  all  that  country.  As  they 
went  out  behold,  they  brought  to  Him  a  dumb  man 
possessed  with  a  devil.  And  when  the  devil  was  cast 
out,  the  dumb  spake  and  the  multitudes  marvelled, 
saying: 

,& 

It  was  never  so  seen  in  Israel. 

But  the  Pharisees  said : 

He  casteth  out  devils  through  the  Prince 

1.    |0  f    I     And  Jesus  went  about  all  the  cities  and 

villages,  teaching  in  their  synagogues  and  preaching 
the  gospel  of  the  kingdom,  and  healing  every  sickness 
and  every  disease  among  the  people.  But  when  He 
saw  the  multitudes  He  was  moved  with  compassion 
on  them,  because  they  fainted,  and  were  scattered 
abroad  as  sheep  having  no  shepherd.  Then  saith  He 
to  His  disciples: 

The  harvest,  truly,  is  plenteous;  but  the 

laborers  are  few.  Pray  ye,  therefore,  the  Lord  of  the 
harvest  that  he  will  send  forth  laborers  into  His  harvest. 
This  may  be  chanted  or  intoned,  the  reader  follow- 
ing the  musical  pitch;  then  sung  staccato;  next,  stac- 
cato without  rests.  While  speech  may  vary  like  song, 
from  the  keynote,  still,  speech  should  close  on  the  key- 
note or  its  chords  like  song.  Often  have  I  heard  male 
speakers  close  on  the  minor  third  octave  below.  Thus, 

taking  P"H  for    keynote,   the   last    few   words  were 

£1 

spoken  in  [9       i  and  the  final  word  in  10  &    I  a  thing, 


12 

I  think,  not  allowed  in  song  harmony,  and  which 
leaves  a  very  bad  impression  on  the  audience,  unless 
it  is  a  funeral  service,  and  even  then  I  doubt  its 
propriety. 

Finally,  the  rule  for  phonation  in  the  chords  of  the 
keynote  of  the  auditorium  is  not  exactly  new.  My 
classmate  at  Yale,  U.  S.  Senator  W.  M.  Stewart  of 
Nevada,  told  me  that  whenever  he  spoke  in  a  new 
place  he  had  a  man  stand  at  the  remotest  part  of  the 
auditorium  who  would  raise  his  hand  above  his  breast 
when  the  pitch  was  too  high,  and  below  his  breast 
when  the  pitch  was  too  low;  but  when  it  was  right 
and  the  audition  was  perfect,  the  man  would  hold  his 
hand  at  his  breast,  still.  The  senator  would  then  ad- 
here to  that  pitch  as  his  central  thread  of  utterance. 
I  think  it  was  he  who  said  that  Cicero  did  the  same 
thing.  But  the  Senator  said  that  he  did  not  know 
before  that  the  pitch  was  the  keynote  of  the  audito- 
rium that  they  were  after  in  phonation. 

BIBLIOGRAPHY. 

The  Physics  of  Phonation  and  Cantation.  Boston  Journal  of  Chemistry, 
January,  1873. 

The  Physics  of  Cantation  and  Phonation.  Boston  Journal  of  Chemistry, 
February,  1873. 

Photographing  the  Larynx.  Archives  of  Laryngology,  New  York, 
July,  1882. 

Relation  of  Phonation  to  Cantation,  witlx-Some  Practical  Deductions. 
Transactions  Ninth  International  Med.  Congress,  Vol.  iv,  1887. 


